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Gentry Brothers, Inc."' "' City of Wpsemead 1N ,b,\ AL, \Rta \' \111 OR PRO 'J rN, M,v,Haxti O.vRn 1(, 8938 1 VA I I Y 110111 F V,ARIIT,) RIIR i99 ('OUNf 11.)IIPIIIY:IIS: T ROSE UAD.('AlJ R ORNIA')1770 YVAmu Ann¢snA �°"0A'^°� 1 P:LIIPIIONT-(6)(I5n9.21011 Ipdv lldl). I',AX(G3o)101 -9 ?IS roLU' I uIe CITY OF ROSEMEAD ROSEMEAD, CALIFORNIA ADDENDUM No. 1 FEDERAL SAFE ROUTES TO SCHOOL WALNUT GROVE AVENUE ENHANCEMENT PROJECT PROJECT No. SRTSL•5358 (016) To All Prospective Bidders: Please note the following revisions on the specifications for the above project: 1. In the Section: "Prevailing Wages' has been updated and shall be replaced with the following attachment of General Decision No. CA140033, Modification No, 16. Dated: 08/2212014. 2. In the Section: "Technical Provisions" has been updated with an addition page "TP- 20. The updated page will include the description for "Unclassified Excavation" for Bid Item No. 3. The quantity shown on the plan for unclassified excavation is an estimate only, and is only to be utilized if applicable to this project. The Addendum No. 1 forms a part of the Contract Documents for the above project and shall supplement or supersede reference sections of original specifications. This Addendum No. 1 must be signed, acknowledge on Page CBF — 4 of the Contract Bid Forms of the Specifications and submitted along with the Bidder's Proposal. BY ORDER OF THE CITY OF ROSEMEAD Date: August 28, 2014 By ---�Rafael —M — Acknowledgement: . Fajardo Associate Civil Engineer Bidder. GENTRY BROTHERSS [/ /I INC A Title: a (" X s s5 Date: i -`3 -/y Page 1 of 1 A City of W9semead If I( A du¢n1c VLATOI<1910'1'r.V: �� BdiNCVAIL(A], If 111.INA 1770 ItOX 3)9 (AV It \IENIt ICII4 .,� "�e ItQSGM1II?AU. CN.IlpRN1A 91]]0 A,aimn Ni, u.aT., TCIFPI II1NP.( 11,>69- -2100 11 �cHa i. rA% (626) ±Ip -021 Y Pisa v l nu' CITY OF ROSEMEAD ROSEMEAD, CALIFORNIA NOTICE OF CLARIFICATION FEDERAL SAFE ROUTES TO SCHOOL WALNUT GROVE AVENUE ENHANCEMENT PROJECT PROJECT No. SRTSL - 5358(016) To All Prospective Bidders: Please note the following clarifications on the specifications for the above project: 1. For BID ITEM No. 14: CONSTRUCT TRAFFIC SIGNAL IMPROVEMENTS AT WALNUT GROVE AVE. AND VALLEY BOULEVARD PER SPECIFICATIONS, please refer to Section "Technical Provision ", page TP -14 of Specifications. 2. For BID ITEM No. 15: INSTALL SIGNAGE, STRIPING, AND PAVEMENT MARKINGS AT VARIOUS LOCATIONS, please refer to Section 'Technical Provision", page TP -16 -17 of Specifications. Under "TRAFFIC STRIPES AND PAVEMENT MARKINGS ", Section 84 -2 THERMOPLASTIC, the Specifications calls for all striping to be thermoplastic. Date: September 2, 2014 Acknowledgement: GENTRY BROTHERS, INC Bidder: Title:a� fo/t Date: Page I of 1 BY ORDER OF THE CITY OF ROSEMEAD / �� By ., Rafael M. Fajardo Associate Civil Engineer BIDDER: GFNTRV BROTHERS, INC BID SCHEDULE SCHEDULE OF PRICES FOR FEDERAL SAFE ROUTES TO SCHOOL WALNUT GROVE AVENUE ENCHANCEMENT PROJECT SRTSL - 5358(016) BASE BID SCHEDULE NO UNIT OF EST. UNIT TEM • ITEM DESCRIPTION MEASURE QTY. PRICE OST 1 CLEARING AND GRUBBING LS 1 _ - TRAFFIC CONTROL AND O 'c' O Cu. j5' 2 BMPS /SWPPP LS 1 " 3 UNCLASSIFIED EXCAVATION CY 264 cc� c w kG0_ 4 COLD MILL 2- INCHES EXISTING PAVEMENT SF 6,800 c° / — koC' CONSTRUCT ASPHALT 5 CONCRETE PAVEMENT (2" TON 186 ' THICK) �-G a�,��c CONSTRUCT P.C.C. CROSS 6 GUTTER PER SPPWC STD. SF 135 122 -2. /4 13 5'C = CONSTRUCT 4 PP.C.C. DRIVE 7 APPROACH PER SPPWC SF 440 �' STD. 110 -2 3 C kC CONSTRUCT4'PCC SIDEWALK INCLUDING 8 EXCAVATION, EXPORT, AND DRIVEWAY SF 5,000 7 APRONS PER _ 3FaCL SPPWC STD. PLAN 113 -2. ' CONSTRUCT P.C.C. CURB 9 PER SPPWC STD. 120 -2 AND 111 -5 LF 1,325 ` CONSTRUCT ADA CURB 10 RAMP PER SPPWC STD. 111- EA 3 a ocv.� 6 'c)c' 11 INSTALL STREET LIGHTS INCLUDING ALL CONDUITS LS 1 12 LANDSCAPE PLANTING AND IRRIGATION CBF -1 BIDDER: GENTRY BROTHERS, INC TOTAL BASE BID PRICE (SCHEDULE BID PRICE):$ 7j- -Z / I S, k"if - j Dollar amount in written form ADDITIVE ALTERNATE A 1. NO CONSTRUCT TRAFFIC UNIT OF MEASURE EST. CITY. UNIT PRICE ITEM COST SIGNAL IMPROVEMENTS AT 13 WALNUT GROVE AVE. AND LS 1 At MARSHALL ST. PER PLANS SF 3250 AND SPECIFICATIONS / L/ �r 2SC CONSTRUCT TRAFFIC SIGNAL IMPROVEMENTS AT 14 WALNUT GROVE AVE. AND LS VALLEY BOULEVARD PER SPECIFICATIONS INSTALL SIGNAGE, 15 STRIPING, AND PAVEMENT LS 1 _ MARKINGS AT VARIOUS LOCATIONS I / TOTAL BASE BID PRICE (SCHEDULE BID PRICE):$ 7j- -Z / I S, k"if - j Dollar amount in written form ADDITIVE ALTERNATE A 1. NO ITEM DESCRIPTION UNIT OF MEASURE EST. CITY. UNIT PRICE ITEM COST CONSTRUCT6 "COLORED PORTLAND CEMENT At CONCRETE CROSS WALK on SF 3250 8" CLASS II AT WALNUT GROVE AND MARSHALL l� S L/ �r 2SC STREET TOTAL ADDITIVE ALTERNATE A BID PRICE (SCHEDULE BID PRICE):$ Dollar amount in written form The undersigned agrees that these Contract Bid Forms constitute a firm offer to the Owner which cannot be withdrawn for the number of Working Days indicated in the Notice Inviting Bids from and after the bid opening date, or until a Contract for the Work is fully executed by the Owner and a third party, whichever is earlier. The undersigned also agrees that if there is a discrepancy between the written amount of the Bid Price and the numerical amount of the Bid Price, the written amount shall govern. CBF -2 BIDDER: GENTRY BROTHERS, INC If the Bid Documents specify alternate bid items, the following Alternate Bid amounts shall be added to or deducted from the Total Bid Price entered above. The owner can choose to include one or more of the alternates in the Total Bid Price of the Project. If any of the Alternate Bids are utilized by the Owner, the resulting amount shall be considered the Total Bid Price for the Project. Attached hereto is a certified check, a cashier's check or a bid bon in the amount of Dollars ($ /(, O ) said amount being not less than ercent (10 %) of the Total Bid Price. The undersigne 4 agrees that said amount shall be retained by the Owner if, upon award, we fail or refuse to execute the Contract and furnish the required bonds, certificates and endorsements of insurance and other certifications within the time provided. CBF -3 BIDDER: GENTRY BROTHERS, INC If awarded a Contract, the undersigned agrees to execute the formal Contract, which will be Prepared by the Owner for execution, within five (5) Calendar Days following the Letter of Award for the Contract, and will deliver to the Owner within that same period the necessary original Certificates of Insurance, Endorsements of Insurance, Performance Bond, Payment Bond and all other documentation and certification required by the Contract. The undersigned offers and agrees that if this bid is accepted, it will assign to the purchasing body all rights, title, and interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 U.S.C. Section 15) or under the Cartwright Act (Chapter 2 of Part 2 of Division 7 of the Business and Professional Code), arising from purchases of goods, materials or services by the Bidder for sale to the purchasing body pursuant to the bid. Such assignment shall be made and become effective at the time the purchasing body tenders final payment to he Contractor. Bidder understands and agrees that, when requested by Owner, he shall provide: (1) evidence satisfactory to the Owner of Bidder's California contractor's license(s) in good standing; (2) evidence that the person signing this Bid is authorized to bind Bidder to this Bid and to a contract resulting therefrom; and (3) any other information and documentation, financial or otherwise, needed by Owner to award a Contract to the lowest responsible and responsive bidder. Bidder understands and agrees that liquidated damages shall apply to this Contract in the amounts and subject to the terms and conditions described in the Contract Form and the Contract Documents. Bidder acknowledges that data submitted with its Contract Bid Forms which it requires to be incorporated into a Contract arising out of this Submittal has been so identified by Bidder. Bidder further acknowledges that the Owner may, at its discretion, incorporate any of the remaining data submitted herewith into a contract arising out of this Bid. The undersigned acknowledges receipt, understanding and full consideration of the following addenda to the Contract Documents. Addenda Nos. The Bidder understands and agrees that the Total Bid Price is inclusive of all labor, materials, and equipment or supplies necessary to complete the Work as described in the Bid Documents. If this bid is accepted, the undersigned Bidder agrees to enter into and execute the Contract with the necessary bonds and accept the Total id Price as compensation in full for all Work under the contract. By: Signatur Business SueerP.3 % '' Mt� ) LNEMAVE. U l3 � ✓� h IRWINDALE CA 91706 Type or Print Name City, State and Zip Code �iS Title Telephone Number CBF -4 BIDDER: GENIRVBRCTHERS INC Bidder's /Contractor's State of Incorporation: Partners or Joint Venturers: Bidder's License Number(s): i, j (� k 2_ NOTES: 1) By its signature on this Bid, the Bidder certifies under penalty of perjury the accuracy of the representations made on the Contract Bid Forms. 2) If Bidder is a corporation, enter State of Incorporation in addition to Business Address 3) If Bidder is a partnership or joint venture, give full names of all partners or joint venturers. As further discussed in the Instructions to Bidders, Bidder will be required to provide evidence that the person signing on behalf of the corporation, partnership or joint venture has the authority to d so CBF -5 BIDDER: Gentry Brothers, Inc. Bidders hall submit its Bid data in accordance with the format shown on each of the following Bid Data Forms. Bidders shall prepare and use as many sheets as are necessary to adequately Provide the information required. Bidder shall ensure that every page of its Bid Data Forrns are properly identified with the Bidders name and page number. 2.A BID BOND KNOW ALL MEN BY THESE PRESENTS: THAT Gentry Brothers, Inc. as Principal, and Federal Insurance Company as Surety, are held ffrmly hound unto the CITY OF ROSEMEAD (hereinafter called the OWNER) in the sum of Ten percent of the total amount of the bid DOLLARS (5 10% 1, being not less than ten percent It 0 %) of the Total Bid Price; for the payment of which sum Will and truly to be made, we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. WHEREAS, said Principal has submitted a bid to the OWNER to perform all Work required for the Federal Safe Routes to School Walnut Grove Avenue Enhancement Project as setforth in the Notice Inviting Bids and accompanying Bid Documents, dated August 27, 2014 NOW, THEREFORE, if said Principal is awarded a Contract for the Work by the OWNER and, within the time and in the manner required by the above - referenced Bid Documents, enters into the written form of Contract bound with said Bid Documents, furnishes the required bonds (one to guarantee faithful performance and the other to guarantee payment for labor and materials) furnishes the required insurance certificates and endorsements, and furnishes any other certifications as may be required by the Contract, then this obligation shall be null and void; otherwise it shall remain in full force and effect. In the event suit is brought upon this bona by the OWNER andjudgment is recovered, said Surety shall pay all costs incurred by the OWNER in such suit, including reasonable atlomeys' fees to be fixed by the court. SIGNED AND SEALED, this 25th day of August 20 14 Gentry Brothers, Inc. (SEAL) Federal Insurance Company (SEAL) Principal Surety By: ��rj ...�2y By: Sign lure DAPS.'o� Signature Maithew lP oats, Attorney in Fad CALIFORNIA ALL - PURPOSE ACKNOWLEDGEMENT State of California County of Orange On AUV 2" 2 before me. Summer L. Reyes, Notary Public personally appeared Matthew J. Coats (insert name and title of the olficer) who proved to me on the basis of satisfactory evidence to be the personf,) whose name{,) is/are subscribed to the within instrument and acknowledged to me that he Yrefthey executed the same in hisArerr'rh authorized capacity(ies), and that by his{hetftheir instrument the erson s)=re ,execut the p tsj, or the entity upon behaffofwhich the person(sj acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. SUMMER L. REYES Commissions 1966627 '^/ e, • `O Notary Pu611c - CalitornI i Signature "Q v a Orange County s My Comm. Expires Ju129.2016 ME Chubb r W N Federal Insurance Company Attn: Surety Department Sure Vigilant Insurance Company 15 Mountain View Road � ry ATTORNEY Pacific Indemnity Company Warren, NJ 07059 Know All by These Presents, That FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York Corporation, and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and apPOint Linda D. Coats and Matthew J. Coats of Laguna Hills, California ---- •----- - - - - -- — each as their True and lawful Aledood, in. Fad to Asti under sum designation in rarer names and to aKrdeir corporate seals In and dev er For and On their eased. r:rery thereon or dMermed. bell and undertakings and coo sarrim 51Mliga101y in Me rNWre tnaredf (00ar the' Dail Who.) Berea Or eM FAMSJ In Ile Course Of bu5ina55, aid any sbu.ments amending or altering the same, and coned"to Me"it- ficsbdn or elteaMnofany insbument analled M in sea bonds w Attempts In ss Whemf, said FEDERAL INSURANCE COMPANY, VIGIIANTINSURANCE COMPANY. and PACIFIC INDEMNITY COMPANY have each eseculed and adestee Made presents and affixed their opene,seals On cola ISt day of December, 2011 ^ Kenneth C. Wendel, ssun eaebry Day d B JL Vice President STATE OF NEW JERSEY County Or Somers% Se. on Mrs let dayor December, 2011 before ma,a Near, PUMP" hers Jersey. parsonally came Kenneth C. Wendel, to me known b be Asssunt Secretary d FEDERAL INSURANCE COMPANY, VIC IUMINT NSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY, to companies shi eaecUMd the twagtlt Pawn AF Attomay, aid the said Ki n raid C. WeMet W I by me guy sworn, did depose and say Mat n is Assslanl Secretary of FEDERAL INSURANCE COMPANY. VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY and MCws Me mryMale weld Mnd, Mal the sank affeed in Me reraed, Pave of Attorney are sum corporate Sank and were Inerg, aMMed by authority OF the By Laws OF said Company; aid that he Signed said Pw.ar of AlMmey as Ass4ant Secretary OF said Con,anea by like autpot, and Mat he is acpwiretetl wth David B. For is, Jr., and kmrva him to Le Vice President 0 said Companies; end Mel Me signatu a OF David B. Nadia, Jr. Abanibm to said Power of Attorney is in the genuine handwrilirg of Call B. Non¢. A, and wad thereto addici ed bydpMOr, Of said BY Laws and in deponent's presence. Nola.;al Seal KATHERINE J. ADELAAR J NOTARY PUBLIC 16 NEW 1Fk5Fy -i NOTARY �L "m B* 6695 S CommiMion EI�ieM July 16, 2011 >UBLIG 1CQ,gy, NONry PuElie CERTIFICATION ENad from the By- Lave OF FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY' 'Al popos, or attomey ror and on behalf of the Company may and Ina" be eeecwed m to name and an benau of the Company, Inner by the Chaimlen pr Me President err a Um Presidenl or an Assistant Ved President , jointly with Me Societe, or an Adustst Se Yal under their frspaphys dea9nahorra. The s1-i of OF- oflcae mry he "'A., Fri on IIIWgrapned. The Stil a Of Wch OF hN:dmng Officers Chairman, PresHeN, any Vim president, any AsASttint Vlce Painful any Secretory, any Around nt Secretary, antl the seal of the Company may be aff snJ by facsimile Io My power of atlIXrRy or to arty wimpale MINIS, thereto appoint, Asyslanl Secrerargs w Aromas, in Fact Mr purposes Only of a flooding OM Mddl bons and undertakings and Met ps otignory is Ma nature Manden end any such power or otbrney or defiBO]le opened Such eadminde signature or bunions seal NOW [¢ Yalta and binding open the Cornpamy and eery cum pave de executed and earl by sum morminiN se mill and faCSITJe Seal shad be Velitl and bMNlt upon Me Company -In resµn to any bond wuMertaks, to which his Stephen' I. Karmen G Werosel. ASai.Fort Sedel of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY (Me'Cdnpau iers) do hereby certify Ma: (d the fdre9oing expect OF Me By- Used Of the Companies is true end mum, (ii) the Cempadgs are duty 1car sea and actin tudd b train ... I d.1, bodur 6'li all he of the Ul States of America and the District Of Columbia and are adroraed by the U 5. TreaZxy DeWnmWtll'uMer. Federal and Vigilant aR LCansad in Puvb mW and the U.S. Vngin Isianda aid Federal15 Murder In American Samoa, Guam, and each of the Phosured of Canada except People Edgard Island; and (iii) Me foregoing Pwrer of Ahwney is true, correct and in fell ford, and effect Cram under myhand and sealsefsed Oampames at Warren, NJ MIS 25th day of August, 2014. p 01. Me &O."tal Secretary IN THE EVENT YOU WISH TO NOTIFY US OF A CLAIM. VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER, PLEASE CONTACT US AT ADDRESS LISTED ABOVE, OR BY Telephone (908) 903 3493 Fox(908)903-3666 emaT somenlyntDcholdi Form 15.10. 0225B- U (Ed. 5 -03) CONSENT CALIFORNIA ALL - PURPOSE CERTIFICATE OF AKNOWLEDGMENT State of: California Countyof: Los Angeles On September 3, 2014 before me,N. Smith, Notary (name and tine dos officer) personally appeared Rodney J. Gentry____________________________________ who proved to me on the basis of satisfactory evidence to be the person (5) whose name (9) is/Aw subscribed to the within instrument and acknowledged to me that he]ey executed the same in hls t3OLFauthonzed capacity (le8}S and that by his /bardbek signature(N) on the instrument the person(* or the entity upon behalf of which the person(obcted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal / N. SMITH 1 � , n 1 y LOMM.d1O125TY /c— AarLAY PUauc. MiaaNIA =1 106 AXOFln Bou /`- C_�/�(71 Mr COPY. E W. APA 2, tOt] 'r Sig ary ublic (Notary Seal) NNY -- ANNOTTIONAL INFORMATION -- - y��re y InfonoatrbelowisNOTre required lawhowevermay deerfraud t removal oRhrscorm Description of Attached Document Capacity Claimed by Signer(s) Numberof Pages 1 Document Date: MM, /L /L ❑ Individual(s) ❑ Corporate Officer Bid Bond----------- --------- ❑ Partner ❑ Attorney -in -Fact ❑ Trustees) Title or type document ❑ Other - Additional information BIDDER: OWRY BROTHERS, INC 2.B LIST OF PROPOSED SUBCONTRACTORS In compliance with the "Subletting and Subcontracting Fair Practices Act," Sections 4100 through 4114 of the California Public Contract Code, and any amendments thereto, each Bidder shall provide the information requested below for each subcontractor who will Perform work, labor or render service to Bidder in or about the construction of the Work in an amount in excess of one -half of one percent (greater than 0.5 %) of the Bidder's Total Bid Price, or, in the case of bids or offers for the construction of streets or highways, including bridges, in excess of one -half of 1 percent of the Contractor's total bid or ten thousand dollars ($10,000), whichever is greater, and shall further set forth the portion of the Work which will be done by each subcontractor, Bidder shall list only one subcontractor for any one portion of the Work. Pursuant to Public Contract Code Section 4104, the Owner has determined that it will allow Bidders twenty-four (24) additional hours after the deadline for submission of bids to submit the information requested by the Owner about each subcontractor, other than the name and location of each subcontractor. If the Bidder fails to specify a subcontractor for any portion of the Work to be performed under the Contract, it shall be deemed to have agreed to perform such portion itself, and shall not be permitted to subcontract that portion of the Work except under the conditions hereinafter set forth below. Subletting or subcontracting of any portion of the Work in excess of one half of one percent (greater than 0.5%) of the Total Bid Price or, in the case of bids or offers for the construction of streets or highways, including bridges, in excess of one -half of 1 percent of the Contractor's total bid or ten thousand dollars ($10,000), whichever is greater, for which no subcontractor was designated in the original bid shall only be permitted in cases of public emergency or necessity, and then only after Owner approval. CBF -7 I a� w n p a e`yJ y w H Sv n P h O C. p � G m m 3 7 =a c o n S -y' O O ma m a� o a ° o 0 0 c rj 5. m w .- O5 m� �n o v o � o � 5 F o � y � F � a N a T o m a v, o a � 6 O Va O 9 9 .'1 � O p 3 0. e 6 O O m y 3 °o 0 n c 0 :l b vi t" O r m n O z n O a a t1 z 0 O L b i=i n T y m ry � 6 O rt y � a � O R " n O � C V T OQ '^ d O w � E as z � o m a r a ao o p1 o e 0 0 a (D � O S O. n n O S o E a o o � y �a c m 0 0 0 0 a 0 n' H 'T A a c a 0 0 3 a E a y 2 z O z n BIDDER: GENTRY BROTHERS, INC 2.13 LIST cOe F PRO PPgSED tltl CONTRACTORS (continued) T"D,, N.2 O ror fisting additional subcontmcbrs.'j Name and Location Description of Work of Subcontractor to be Subcontracted - Name: ., �J.sa,., ,. ,�..�.��'.{ [/�a.. Address:_ (_, ,, ,, .mot K. Name and Location Description of Work of Subcontractor to be Subcontracted Name:- �6�,�,,. („�/ �n,,.c�r Address: /� Name and Location Description of Work of Subcontractor to be Subcontracted Name: Address: i Name and Location of Subcontractor Name: Address: Name and Location of Subcontractor Name: Address CBF - 10 Description of Work to be Subcontracted Description of Work to be Subcontracted BIDDER: GENTRY BROTHERS, INC 2.0 REFERENCES The following are the names, addresses and telephone numbers for three public agencies for which BIDDER has performed similar work within the past two (2) years: 1. 4-01A-4 Name and Address of Owner Name and telephone number of person familiar with project Contract amount Type of Work Date Completed 2. Name and Address of Owner Name and telephone number of person familiar with project Contract amount Type of Work Date Completed and Address Name and telephone number of person familiar with project Contract amount Type of Work Date Completed 4. Name and Address of Owner Name and telephone number of person familiar with project Contract amount Type of Work Date Completed CBF - 11 | ,.f k Q : - - ^�} } \ \) \)(\ | r 8,0 § §| / \ - �. # 0` § \ ! )!!!® -- | - ! ! ;! ! ; !C? § ; ! § }\ ■( �! |! ;!!f_\ N N a d o a � 1 4a ¢ w CC °° °o Q r „F N W w N M � S 32 � N U N S o N n ° C W P o a t — z x E N O U K 0 5 - m Kp E rc o .� <u t c o E 2 G` 2 _ NS m wc>mry A N > w� N #° N 3��'° rcry qw 5'2�2 v of �¢tlorV 00 `a #vex =i ' m� ¢ u @) afi ¢ A > EN m.4O di o d c p ti = T 2 �� 0 W m¢ G E D i Z m K 3 N m � a m a °z 6 w g E o' m a' g a p v ¢ _ U i E v` 2 $ y 6 m c m A c 5 m m R o c m E v v 3 o o 0 D "m c "m Z v v w o 3 p a � E m o 3 `o ° ° o v 3 0 `v 0 0 �° 0 r- 0 0 0 0 v v v v v v °. v o o u U N� U y V N N a CITY OF ROSEMEAD FEDERAL SAFE ROUTES TO SCHOOL WALNUT GROVE AVENUE ENHANCEMENT PROJECT SRTSL- 5358(016) The Bidder shall list the name and address of each subcontractor to whom the Bidder proposes to subcontract portions of the work, as required by the provisions in Section 2 -1.01, "General," of the special provisions. EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder GENTRY BROTHERS, INC subcontractor hereby certifies that he has41 has not _, participated in a previous contract or subcontract subject to the equal opportunity clauses as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has fled with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due underthe applicable filing requirements. NOTE: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60 -1.7 (b) (1), and must be submitted by bidders and proposed Subcontractors only in connection with contracts and subcontracts which are subject to the Equal Opportunity Clause. Contracts and subcontracts which are exempt from the Equal Opportunity Clause are set forth in 41 CFR 60 -1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt). Currently, Standard Form 100 (EEO -1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime CONTRACTORS and Subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60 -1.7 (b) (1) prevents the award of contracts and subcontracts unless such CONTRACTOR submits a report covering the delinquent period or such other period specilied by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. EEOC -1 CITY OF ROSEMEAD FEDERAL SAFE ROUTES TO SCHOOL WALNUT GROVE AVENUE ENHANCEMENT PROJECT SRTSL- 5358(016) NOWCOLkUSION AFFIDAVIT Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the City of Rosemead, Los Angeles County DEPARTMENT OF PUBLIC WORKS. In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidderto put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. NA -1 CITY OF ROSEMEAD FEDERAL SAFE ROUTES TO SCHOOL WALNUT GROVE AVENUE ENHANCEMENT PROJECT SRTSL- 5358(016) DEBARMENT AND SUSPENSION CERTIFICATION DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he /she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: • is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; • has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years: does not have a proposed debarment pending; and has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. DSC -1 CITY OF ROSEMEAD FEDERAL SAFE ROUTES TO SCHOOL WALNUT GROVE AVENUE ENHANCEMENT PROJECT SRTSL- 5358(016) 14 WRQ .BYING 6E TI f QeT[ON NONLOBBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: 1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. 2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form -LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such sub recipients shall certify and disclose accordingly. NLC -1 CITY OF ROSEMEAD FEDERAL SAFE ROUTES TO SCHOOL WALNUT GROVE AVENUE ENHANCEMENT PROJECT SRTSL- 5358(016) DISCLOSURE OF LOBBYING DISCLOSURE OF LOBBYING ACTIVITIES 1. Type of Federal Action: 2. Status of Federal 3. Report Type: Action: a. contract ® a. bid/ofter /application a. initial b, grant b. initial award b. material change c. cooperative agreement c. post-award d. loan For Material Change Only: e, loan guarantee year _ quarter f loan insurance date of last repair 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: (attach Continuation Shect(s) if necessary) 15. Continuation Sheet(s) attached: Yes ❑ No 16. Information requested Waugh this fruit is sidar aed by Title 31 U 5 C. Section 1352. This disclosure of lobbying Signature' reliance was placed by the lie, above when his transaction was made or entered into. This disclosure is required Print Name ur� pursuant to 31 US.0 -1352_ this information will be reported to Congress semiannually and will be available for + publicinspection _Anypersonwhnfailsmfilethere ,trued Inls: disclosure shall be subject to a civil penalty afoot less than $10,000 and not more than $100,000 for each such failure telephone No _LILS ? S " S4:; I Drum Aulhomrd for I rx al Reproduction Federal Use Only: Standard Form - LI,L DLA -1 dPrime Subawardee Pier if known 90L 16 VO 31 VONIM61 40MY BROTHERS INC MY AVO MIT r6£ 384 LIVE OAK AVE ONI S631110aa AWN30 IRWINDALE CA 91706 Congressional District, if known Congressional District, ifknown 6. Federal Department/Agimey: 7. Federal Program Name/Description: r JON CFDA Number, ifapplicable R. Federal Action Num her, if known: 9. Award Amount, ifknown. ." -, e/ 10. a. Name suit Address of Lobby Entity b. Individuals Performing Services (including (If individual, last nome, first name, MI) address if different from No. I0a) (last name, first name, MI) �pNl° (attach Continuation Shect(s) if necessary) 11. Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) actual ❑ planned o retainer b_ one -time fee 12. Form of Payment (check all that apply): a commission d. contingent fee Ba. cash b. 'n -kind; specify nature a deterred value f. other, specify 14. Brief Description of Services Performed or to be performed and Dates) of Service, including offieer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Shect(s) if necessary) 15. Continuation Sheet(s) attached: Yes ❑ No 16. Information requested Waugh this fruit is sidar aed by Title 31 U 5 C. Section 1352. This disclosure of lobbying Signature' reliance was placed by the lie, above when his transaction was made or entered into. This disclosure is required Print Name ur� pursuant to 31 US.0 -1352_ this information will be reported to Congress semiannually and will be available for + publicinspection _Anypersonwhnfailsmfilethere ,trued Inls: disclosure shall be subject to a civil penalty afoot less than $10,000 and not more than $100,000 for each such failure telephone No _LILS ? S " S4:; I Drum Aulhomrd for I rx al Reproduction Federal Use Only: Standard Form - LI,L DLA -1 INSTRUCTIONS FOR COMPLETION OF SF -LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt ofcovered Federal action or a material change to previous filing pursuant to title 31 U.S.C. section 1352. 'fhe filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information ifthe space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. I. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered Federal action. 1 Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow -up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name, address, city, state and zip code ofthe reporting entity. Include Congressional District if known. Check the appropriate classification ofthe reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier ofthe subawardee, e.g., the first subawardee ofthe prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. Ifthe organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, state and zip code ofthe prime Federal recipient. Include Congressional District, ifknown. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name, ifknown. For example, Department of Transportation, United Stales Coast Guard. Z Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application /proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP -DE -90 -001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount ofthe award/ loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, state and zip code ofthe lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action. (b) Enter the full names of the individuals) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. Ifthis is a material change report, enter the cumulative amount ofpaymenl made or planned to be made. 12. Check the appropriate box. Check all boxes that apply. Ifpayment is made through an in -kind contribution, specify the nature and value ofthe in -kind payment. 13. Check the appropriate box. Check all boxes that apply. Ifother, specify nature. 14. Provide a specific and detailed description ofthe services that the lobbyist has performed or will be expected to perform and the dates) of any services rendered. Include all preparatory and related activity notjust time spent in actual contact with Federal officials. Identify the Federal officers) or employee(s) contacted or the officers) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his /her time title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348- 0046), Washington, DC. 20503. DLA -2 CITY OF ROSEMEAD FEDERAL SAFE ROUTES TO SCHOOL WALNUT GROVE AVENUE ENHANCEMENT PROJECT SRTSL- 5358(016) DBE GQNIMF "!'w LOCAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM //' LCAL AGENCY: C .'�c) ., I� BSc r+. srt °) LOCATION- ��A�.. -'� �� °.��% ✓ <•. PROJECT DESCRIPTION: TOTAL CONTRACT AMOUNT_ S BID DATE a — BIDDERS NAME. GENTRY BROTHERS, INC: CON 'I RAC 'I DBE GOAL: ANTRACT 'rEM NO. TEMOFWORRAND DESCRIPTION RSEPNICES TO BE 'CBCONTRAC'EEDORMAHERIALS O BE PROVIDED (or nmtractedifthe adder is a DBE) DE CGRT NO. NDFXPIRATION DATE AME OF EACH DBE. (Must be certified on the date bids reopened - Include DBE address mal phone number) OLI_4RAMOUNF BE tc ,r 1,. n,' 2 rc,ca Total Claimed DRF Partieipamn For Local Agency to Complete: Local Agency Contract Nerri _ Federal -aid Project Number: Federal Share_ Contract Award Dote: Local Agency Cenifiea tbatall DBE unifications havebecnvevi6edand informalmn is complete and accurate. $ �' % Signature of Bid S 3)v 6zd 3fr4�3) Date (AreaCode) Ist No �,j A -,✓� ^ti PnntName Signature Dam Local Agency Representative (Area Code) Telephone Number reason to Cannot (Pleas Lofnl Agency Bidder DBE C(on ttnt(Connmgion Contracts) (RCV 6261N) Distribution (1) Copy— Fax or seen o copy to the Callous District Local Assistance Enginecr(DLAE) within 30 Jays ofecntou, ezecntion_ Failure to end a copy to the DLAE within 30 days of wnlmd execution may result in de-obligation offends for this pro)ect. L) Copy — Include in award package to Calton District Leeal Assistance (3)On,mal —Local agency files DBEC -1 INSTRUCTIONS - LOCAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS) ALL BIDDERS PLEASE NOTE: This information may be submitted with your bid. If it is not, and you are the apparent low bidder or the second or third low bidder, it must submitted and received as specified in the Special Provisions. Failure to submit the required DBE, commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract DBE Goal. 'fhe form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. Prime contractors shall indicate all work to be performed by DBEs including, if the prime is a DBE, work performed by its own forces, if a DBE. The DBE shall provide a certification number to the Contractor and expiration date. Enter the DBE prime's and subcontractors' certification numbers.The form has a column for the Names of DBE contractors to perform the work (who must be certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless of tier. Names of the First- Pier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the DBE participation dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts), to determine how to count the participation of DBE firs. Exhibit 15 -6 must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Award, Federal -aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and filing. DBEC -2